A Towson cardiologist and his former employer disputed claims during a civil trial Tuesday made by 21 plaintiffs who allege that the doctor performed unnecessary stent procedures to treat heart patients.

Dr. Mark Midei, St. Joseph Medical Center and Catholic Health Initiatives are being sued in Baltimore County Circuit Court by former patients of Midei, who claim that the doctor completed an excessive number of the procedures and that the hospital failed to provide any oversight, leaving the patients with lasting medical complications.

Midei was forced to resign from St. Joseph in 2009, and his medical license was revoked in 2011. The University of Maryland Medical System bought the troubled hospital in December.

Midei's attorney, David J. McManus, said that the stents were a life-saving procedure for patients with existing cardiac conditions and that they had been referred by their physicians to Midei.

"Their symptoms improved. They feel better," McManus said during his opening statement Tuesday. The risk of not fixing a blockage with the wire mesh stents to prop open their arteries outweighed taking no action, he said.

However, the plaintiffs' attorney, Gerry Mitchell, said the patients are suffering long-term complications from taking medications, such as Plavix, that are required for most patients after the procedure. The medication causes some patients to experience bleeding and bruising.

Mitchell said the patients, including a longtime educator from Baltimore, a police officer and a baker, spoke of pain caused by taking medications associated with the procedure and distrust of physicians after feeling betrayed by their doctor.

They allege that Midei sped through procedures in order to complete as many as he could, racking up profits for himself — because he was paid based on performance. They said that the hospital looked the other way, also benefiting from the expensive procedure.

Mitchell said he plans to call numerous expert medical witnesses who evaluated the patients' records and found that the patients did not fall within widely regarded guidelines necessary to require the procedure.

"It was misrepresentation," he said.

McManus said that Midei worked exclusively in stent procedures, which made him more efficient. He said Midei often worked months without vacations and on weekends, contributing to a higher number of stent procedures.

McManus said that the doctors who are now evaluating Midei's former patients have the benefit of hindsight and added that the evaluations are not exact — that each medical professional might rate a patient's need for the procedure differently.

"It's an estimate. ... With all this great science and highly trained people, they're eyeballing it," McManus said.

The attorneys representing the hospital and Catholic Health Initiatives are expected to give an opening statement Wednesday.

Heather and Kevin Mager were looking for a church they could call their own. The young couple attended services at several in the Towson area. One Sunday, they walked into Calvary Baptist Church and, in a sense, never left.